| NPI | 1437767209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NV S4-134) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00204430) |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2023-08-11 |